Pharmaceutical companies are increasingly focusing on patient support programs—initiatives to improve access to, usage of, and adherence to prescription drug treatments. Driven by greater patient involvement in health decisions, an increasing emphasis on patient outcomes, the rise of drug patent expiries, and the growth of specialty drugs that require additional patient support.
Manage inbound hotline calls and status updates about both case and access to care programs from patients, MDOs and Clinical Specialists. Track case from phone and fax channels. Pre-screen for relevant information and documentation. Working with patient/MDO to collect any additional documentation.
Case handoffs between intake, benefits investigation, appeals and access to care programs. Get starter prescription delivered to patient, specialty pharmacy referral, coordiante shipment, returns management, claims management, re-enrollment, case closure and external partner collaboration.
Follow up with patients, MDOs and payers to ensure all relevant information is present to move forward. Review patient benefits to understand coverage. Prior authorization and approvals. Co-Pay assistance and payer knowledge base management by tracking payer information to reduce manual search.
Follow up with patients, doctors and payers for relevant information. Review case information and best approach. Work with MDO to re-file claim. Draft appeal and track for approval. Appeal knowledge base management to reduce manual searching and provide better information to patients and MDOs.
Reimbursement & Access
Review patient’s medical, insurance and financial information to determine whether or not they qualify for access to care. Determine if partial payment is required and secure agreement. Manage invalid prescription
Health Cloud Extension
Review patient’s medical, insurance and financial information to determine whether or not they qualify for access to care. Determine if partial payment is required and secure agreement; manage invalid subscription.
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Cereblis LLC, 1770, Park Street,
Suite 108, Naperville IL 60563.